JP2891669B2 - Solution mixing transfer device and perfusion device - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a liquid mixing / transferring device for mixing two different kinds of mother liquors to produce and transfer a third solution having a composition different from that of the mother liquor, and to use such a device. The present invention relates to an apparatus for perfusing a cardiac arrest solution. Although the perfusion apparatus of the present invention is useful for preparing and transferring a blood cardioplegia solution, it is equally effective for preparing and transferring a cooler, crystalline-based cardioplegia solution.

[0002]

BACKGROUND OF THE INVENTION Surgery on the interior or surface of the heart involves the selective perfusion of a number of substances (primarily potassium K and magnesium Mg) into the coronary arteriovenous ducts of the heart, resulting in the heart. The emergence of a method for maintaining the activity arrest state (cardiac arrest state) has made it possible to perform it more safely. These substances are added to purify the crystalline base solution (crystalline cardiac arrest method) or blood-based solution (blood cardiac arrest method). Optimal temperatures for these solutions are different, especially for crystalline-based solutions, where lower temperatures are optimal, so that two differently designed devices to achieve their respective optimal temperatures are needed to achieve cardiac arrest. , And the operation of switching from one device to the other device or selecting any device was not easy.

[0003] Also, it has been common practice to use two roller pumps to adjust the transfer speed of two or more solutions, especially drug solutions. Arranging two or more pump head tubes with different inner diameters and the same wall thickness along the same transfer wall (raceway) of a single roller or finger type pump can electrically control the two or more pumps. Attempts have already been made because there is no need to synchronize them. In each of these conventional devices (especially in the latter device), an air trap having a complicated structure is used in order to perform filling (priming) without air bubbles entering the pump head tube member. A bubble removing member was incorporated.

The above-mentioned bubble removing member has a complicated structure, but is provided in a mixing chamber in order to act on both solution components. For this reason, it was not possible to separately fill each component system with a different solution from the beginning, and it was not possible to perfuse a solution not containing one of the solution components, for example, a blood containing no additive. To accomplish this, a separate transfer system with a separate pump was required.

SUMMARY OF THE INVENTION The present invention has been made in view of the above circumstances, and uses a common single pump head to flow two different fluids at a specific flow rate ratio to form a third mixed liquid. It is an object of the present invention to provide a solution mixing / transporting apparatus and a perfusion apparatus which can be used not only as a solution but also can be used for perfusion of only one component, and have a relatively simple structure, and are excellent in economy and reliability. Aim.

[0006]

SUMMARY OF THE INVENTION In order to achieve the above object, the present invention provides a solution mixing and transferring apparatus for mixing two kinds of mother liquors to produce and transfer a third solution having a composition different from that of the mother liquor. A pair of pump head tubes having a predetermined cross-sectional area ratio such that the flow ratio of the mother liquor becomes a predetermined value is disposed in a single pump head, and the pump head includes:
A single pressing means for simultaneously handling the pair of pump head tubes and sending out the mother liquor at the flow rate ratio is provided, and a single transfer tube is provided downstream of the pair of pump head tubes from the pump head. The third solution is connected to transfer the third solution.

Here, the pair of pump head tubes have the same wall thickness and different tube diameters (accordingly, the lumen cross-sectional area).
The third fluid is preferably selected such that a predetermined flow rate ratio is obtained by setting a predetermined cross-sectional area ratio, and a desired composition of the third fluid is obtained. On the other hand, the single pressing means of the pump head may be any type of conventional roller type, finger type, etc., as long as it simultaneously handles the pair of pump head tubes and sends out the mother liquor at the predetermined flow rate ratio. It is preferable, but preferably, a transfer wall or a raceway on which the pair of pump head tubes are disposed at the same time, and handling means such as a roller for transferring the fluid by handling the pump head tube with respect to the transfer wall. And a single drive source such as a motor for driving the handling means. It is a matter of course that the tube diameter, wall thickness and the like of the transfer tube are set in consideration of the tube diameter and the like of the pair of pump head tubes.

According to the present invention, the pair of pump head tubes can be operated independently as two mutually independent substantially parallel tube systems. In a preferred aspect, the recirculation branch channel is located upstream of a mixing point (a downstream end of each head tube at a connection point of the transfer tubes) at an upstream portion (arm portion) and a downstream portion (arm portion) of the pump head tube. A bubble removing means is provided in each of the recirculation branches.

[0009] In a further preferred aspect of the present invention, the air bubble removing means provided in the recirculation branch is open to the outside air, has a storage function, and is provided in series with each recirculation branch. In addition, the solution mixing / transporting device of the present invention is specifically used mainly as a perfusion device for a solution in a cardiac arrest method, but in such a case, it is actually used to support circulation of a patient. The extracorporeal circuit (cardiopulmonary bypass) from which the blood is drawn has its own bubble removal member (cardiotomy storage container) and is used as for the circulating components of the blood line. On the other hand, the bubble removing means for the solution of the second component or the additive is also provided in series in the recirculation branch, but the lumen of the recirculation branch is connected to one side and the chamber is connected to the other side. Provided in a chamber adapted to hold the added mother solution in the form of a coaxial rod, the fluid is guided by the rod and returns to the chamber without being scattered, and the bubbles are coalesced and pass through the air exhaust port of the chamber. Preferably, it is configured to be removed from the chamber.

In another preferred embodiment of the invention, a standard tubing connector can be fitted, and two connecting ends (pouches or bladders), usually fitted with blind plugs, are used to recirculate the blood line. It is provided parallel to the road. When the device of the present invention is used as a perfusion device, when it becomes necessary to perfuse unmixed blood,
The cardioplegia mixed solution transfer line is clamped and each component returns to the source through each recirculation branch. The added components are recirculated back to the mother chamber, and the unmixed blood flows through the recirculated diversion channel to the cardiopulmonary bypass cardiotomy reservoir.
When one of the blind connection ends of the recirculation line is connected to a brain tube or the like, unmixed blood can be perfused into the brain and other devices. Further, in a preferred aspect of the present invention, in order to be able to induce hypothermia in a short time, an efficient heat exchanger without time lag is used as a main component, that is, a recirculation branch of a blood line. It is provided at a more upstream site. With such a configuration, a single pump can safely and alternately perfuse both heart and brain organs at two different desired temperatures.

[0011] Since selective cerebral perfusion is not required for the majority of cardiac surgeries, a blood concentrator can be interposed in series between the two blind connection ends, and the heart Perfusion can likewise be performed alternately. Therefore, blood concentration can be performed using a pump used for transferring a cardiac arrest method solution.

Since the transfer of any cardiac arrest solution is almost always required for cardiac surgery, connecting the device of the present invention for cardiopulmonary bypass devices will result in the perfusion of the brain or blood concentrator. Eliminating the need for a separate circuit and a separate pump makes it possible to make a secure connection at any time during surgery, especially after the onset of cardiopulmonary bypass, which is usually not possible with commonly available devices. it can.

[0013]

Embodiments of the present invention will be described below with reference to the accompanying drawings, but the present invention is not limited to these embodiments.

FIG. 1 shows a basic structure of a solution mixing / transferring device or a perfusion device according to the present invention, in which an additive: base liquid such as blood has a flow ratio of 1: 9. However, it should be understood that the principles can be applied to many other flow ratios.

In the present apparatus, a pair of pump head tubes 1 and 9 having different inner diameters and the same wall thickness are arranged side by side and in parallel, and the upstream end of each pump head tube is connected to a supply source BS and a supply source of each mother liquor. Source (chamber) I or
While each is connected to II, the downstream end joins to form one transfer tube 10. Thus, the mother liquor flowing from the source BS and the source I or II is mixed in the transfer tube 10 to create and transfer the third solution.

The two pump head tubes 1 and 9 are provided along a single transfer wall or a raceway (not shown) of a single pump head, and are handled by a common roller 12 of the pump head. Thus, each solution is transferred, and the mixing ratio of the solution in the transfer tube 10 is set to a desired value by the cross-sectional area ratio of each tube, and the pump speed (only the total flow rate of the final mixture is determined) and Is irrelevant. In the illustrated example where the ratio of the cross-sectional areas of the two tubes is 1: 9, the concentration of the additive in the mixed solution created after the mixing point (connection point of the transfer tube 10) is the concentration of the mother liquor in the source I or II. 1/10 of

Each of the pump head tubes 1 and 9 is provided between each supply source provided at the upstream end (inlet arm) and a portion near the downstream end (outlet arm) and upstream of the mixing point. Are connected to the recirculation channels 1R and 9R. Thus, if it is desired to transfer unmixed blood or unmixed solution I or II at the cardioplegia transfer end, a predetermined site upstream of the mixing point will be blocked by clamp E and any recirculated diversion will occur. Roads 1R and 9R are circulated.

However, the configuration of the recirculation channels 1R and 9R enhances the usefulness of the entire system. That is, both recirculation branch channels 1 are provided by a single clamp A.
When the Aa positions of R and 9R are clamped, the mixed mother liquor, that is, the mixed solution of the cardiac arrest method can be transferred. on the other hand,
When the Ab position is clamped by the clamp A to open the recirculation branch, the forward flow for producing the mixed solution in the cardiac arrest method is not formed, and the unmixed solution is removed from each recirculation branch 1.
Circulated separately through R, 9R, the unmixed blood from the cardiopulmonary bypass is transported to different organs or devices.

A bubble removing mechanism is provided for each perfusion component system, that is, for the additive in the supply chamber I or II, and for the blood line in the cardiotomy storage container CR of the cardiopulmonary bypass circuit CPB. With this configuration, each solution can be independently recirculated before the components are mixed, so that air bubbles can be easily removed and filled.

Further, the one recirculation branch channel 9R is provided with two connection ends H and HR to which a tube connector can be detachably attached and to which a blind plug is normally attached, as shown in FIG. Or a bag containing a cerebral perfusion line 9Rb, a blood concentrator HC as shown in FIG. 5, or a crystalline cardiac arrest base solution as shown in FIG. 6 (III-CS)
The connection is detachably connected via a standard connector.

Also, both pump head tubes 1, 9
The three-way cock 13 is connected between the inlets of the chambers, thereby easily removing the initial air bubbles in the chambers I and II and the recirculation branch.

Further, an efficient heat exchanger ΔT with no time delay is provided at a position slightly upstream of the mixing point of the blood perfusion line, and the action of this heat exchanger reduces the blood temperature (T). It can be adjusted to a desired value, and two different organs, such as the heart and brain, can be perfused alternately at two different temperatures and compositions during surgery on the aortic arch.

FIG. 2 shows a bubble removing mechanism (bubble removing means) provided in the supply chamber I or II for containing one mother liquor (additive solution) in the additive circulation path. The air bubble removing mechanism is coaxially inserted into a tube serving as a recirculation distribution channel, and accommodates a rod Ir or IIr substantially reaching the bottom of each supply chamber, and an opening 16 provided at an upper portion of the chamber. And
The rod Ir or IIr serves as a guide when the recirculating fluid falls into the chamber, preventing scattering and foaming around the recirculating fluid, and air in the fluid is united and discharged out of the chamber from the opening. . Each chamber is pre-scaled, and the total volume of the mixed solution can be easily calculated by multiplying the amount of the additive obtained from the scale by 10. Further, as can be seen from FIG. 2, each of the two supply chambers connected in parallel is connected to a respective recirculation branch channel 1R,
By switching clamp B from chamber I to chamber II or vice versa, two different compositions for the additive can be selected and switched almost instantaneously.

It is to be noted that a porous membrane filter can be provided in the recirculation branch to remove air. However, if the rod is used as described above, it is only necessary to remove air bubbles existing in the recirculation fluid. Rather, it prevents bubbles from being created when the fluid returns to the chamber due to its splashing.

FIG. 3 shows a chamber I or II provided in a plastic bag in which the mother addition solution is stored.
It is the schematic which shows the modification of the bubble removal means of an additive system.
Instead of the rods Ir and IIr in the example shown in FIG.
An end of the recirculation line 1R is extended, and an upper portion formed in the chamber is disposed and mounted in a funnel-shaped partition chamber. The recirculation fluid overflows from the end into the chamber. When returning, the funnel-shaped portion flows down along the outer surface of the end portion or the inner wall of the plastic bag without being scattered into the chamber, so that the scatter of the fluid and the formation of bubbles are reliably prevented. Further, each of the chambers I and II is provided with an air exhaust hole 16 opened to the atmosphere, and when the fluid returns to the chamber, the combined air bubbles are discharged to the outside. Further, a three-way cock 15 is provided in the supply line of the additive, and is disposed above the funnel-shaped portion so that the added fluid does not scatter when flowing down in the chamber. The other structures are the same as in the example of FIG. 2, such as a scale is provided in advance for each chamber.

FIG. 4 is a schematic diagram of a cardioplegia solution transfer and circulation device modified to be used for intermittent cerebral perfusion. The recirculation branch 9R is provided with two connection ends H and HR, and one connection end H is connected to a cerebral perfusion line 9Rb. The connection of this line can be made at any time without interference with the main cardiopulmonary bypass. When the clamp C is held at a position downstream of the connection end H of the recirculation branch 9R, unmixed blood from the cardiopulmonary bypass can be perfused into the brain, and the additive is recirculated to the chamber I or II. Return. Since the blood line 9 is provided with an effective heat exchanger ΔT that enables the control of the temperature (T) with a minimum time delay, the temperature of the transferred blood is supplied to each organ upon perfusion upon request. Can be adjusted. The selection of the perfusion organ is made simply and safely by simply switching the clamp A from the Aa position (cardiac arrest mixed solution transfer position) to the Ab position (brain perfusion position with unmixed blood) (FIG. 1).
See also).

FIG. 5 is a schematic diagram of a cardioplegia transfer circulator that can also be used as a hemoconcentration or hemodialysis system HC. The hemodialysis system HC is provided in series between the connection end H and the HR provided in the recirculation branch channel 9R. Thus, if no cardiac arrest solution has been transferred, the blood in the cardiopulmonary bypass can be concentrated by recirculating the blood through the hemodialysis system HC.

FIG. 6 is a schematic diagram showing the basic structure of a blood arrest transfer / circulation apparatus used for the crystalline cardiac arrest. Basically, to carry out the so-called end-stage cardiac arrest warm-blooding method often used by those who rely on the crystalline solution, a bag III containing the crystalline solution CS is provided in the circulation device shown in FIG.
Is connected to the connection terminal Cp, and the clamp D enables selection of either blood from the cardiopulmonary bypass BS or the crystalline solution CS. Since the crystalline solution CS requires a lower temperature, a connecting line CSR is connected to the connecting end H to transfer the contents of the bag III to the heat exchanger ΔT during intermittent cardiac surgery. Must be circulated through to reduce to the desired temperature, during which time the recirculation branch 9R is clamped by the clamp C. This Between recirculation / cooling phase, the oxygen added through the O ₂ ports provided in the recirculation connection path CSR is performed. The above-mentioned bag III is used as a container for storing all of the remnant of the filling liquid in the cardiopulmonary bypass circuit, and after the operation is completed, the patient can be separated from the cardiopulmonary bypass and the remaining blood can be injected back.

[Brief description of the drawings]

FIG. 1 is a schematic configuration diagram of an apparatus according to a first embodiment of the present invention.

FIG. 2 is a schematic view showing a bubble removing unit in an apparatus according to a modification of the present invention.

FIG. 3 is a schematic view showing a modification of the bubble removing means.

FIG. 4 is a schematic configuration diagram in a case where the device of the present invention is configured to be used for perfusion of the brain.

FIG. 5 is a schematic configuration diagram when the device of the present invention is configured to be used in combination with a blood concentrator and the like.

FIG. 6 is a schematic configuration diagram in a case where the device of the present invention is particularly adapted to perfusion of a solution of a crystalline cardiac arrest method.

[Explanation of symbols]

 1, 9: pump head tube I, II: additive supply source BS: blood supply source 1R, 9R: recirculation branch channel 10: transfer tube A, B, C, D, E: clamp 12: roller 13, 14, 15: Three-way stopcock H, HR: Connection end △ T: Heat exchanger 16: Air exhaust hole

Claims (6)

(57) [Claims] 1. A solution mixing and transferring apparatus for mixing two kinds of mother liquors to produce and transfer a third solution having a composition different from the composition of the mother liquor, wherein the flow rate ratio of the mother liquor becomes a predetermined value. A pair of pump head tubes having a predetermined cross-sectional area ratio are provided on a single pump head, and the pump head simultaneously handles the pair of pump head tubes and sends out the mother liquor at a single flow rate at the flow rate ratio. Means, and a single transfer tube is connected to a downstream portion of the pair of pump head tubes from the pump head, so as to transfer the third solution. Solution mixing and transfer device. 2. A recirculation branch channel is connected between an upstream portion of each pump head tube and a downstream portion of the pump head tube from a connection point with a transfer tube. The solution mixing and transferring apparatus according to claim 1, further comprising: 3. The solution mixing and transferring apparatus according to claim 2, wherein said air bubble removing means has a function of storing a fluid. 4. A perfusion apparatus for mixing two mother liquors to produce and transfer a cardioplegic blood base solution having a composition different from that of the mother liquor, wherein the flow ratio of the mother liquor is a predetermined value. A pair of pump head tubes having a predetermined cross-sectional area ratio are provided on a single pump head, and the pump head simultaneously handles the pair of pump head tubes and sends out the mother liquor at a single flow rate at the flow rate ratio. Means, and a single transfer tube is connected to a downstream portion of the pair of pump head tubes from the pump head so as to transfer the cardioplegic blood-based solution. A perfusion apparatus characterized by the above-mentioned. 5. A recirculation branch is connected between an upstream part of each pump head tube and a part upstream of a connection point with a transfer tube at a downstream part, and a bubble removing means is provided in each recirculation branch. And at least one pair of blind connection ends to which a tube connector can be attached is provided on one of the recirculation branches, and a circulation path for perfusion to other organs or the like is connected to the blind connection end. The perfusion apparatus according to claim 4, wherein the apparatus is enabled. 6. The perfusion apparatus according to claim 5, wherein a heat exchanger is provided at a position upstream of one of the recirculation channels of the pump head tube.